Mental Health and Substance Abuse Benefits Sample Clauses

Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) arranges and administers Mental Health Services and Substance Abuse Services for Blue Shield Members within California. See the Out-Of- Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Substance Abuse Services are subject to the Benefits Management Program and must be prior authorized by the MHSA. See the Benefits Management Program section for complete information.
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Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administra- tor (MHSA) arranges and administers Mental Health Services and Substance Abuse Services for Blue Shield Members within California. See the Out-Of-Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Substance Abuse Services are subject to the Benefits Management Program and must be prior authorized by the MHSA. See the Benefits Man- agement Program section for complete informa- tion Routine Outpatient Mental Health and Substance Abuse Services Benefits are provided for professional (Physician) office visits for the diagnosis and treatment of Mental Health Conditions and Substance Abuse Conditions in the individual, family or group set- ting Non-Routine Outpatient Mental Health and Substance Abuse Services Benefits are provided for Outpatient Facility and professional services for the diagnosis and treat- ment of Mental Health and Substance Abuse Con- ditions. These services may also be provided in the office, home or other non-institutional setting. Non-Routine Outpatient Mental Health and Sub- stance Abuse Services include, but may not be lim- ited to, the following:
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Mental Health and Substance Abuse Benefits. 11 All services provided through Blue Shield’s Mental Health Service Administrator (MHSA). Services by MHSA Participat- ing Providers Services by MHSA Non- Participating Providers 10 Inpatient Mental Health and Substance Abuse Services Inpatient Hospital services $100 per admission plus 10% 40% of up to $600 per day 12 Inpatient Professional (Physician) services You pay nothing 40% Residential care for Mental Health Condition $100 per admission plus 10% 40% of up to $600 per day Residential care for Substance Abuse Condition $100 per admission plus 10% 40% of up to $600 per day Non-Routine Outpatient Mental Health and Substance Abuse Services Behavioral Health Treatment in home or other non-institutional set- ting You pay nothing 40% Behavioral Health Treatment in an office-setting You pay nothing 40% Electroconvulsive Therapy (ECT) 14 You pay nothing 40% Intensive Outpatient Program 14 You pay nothing 40% Office-based opioid treatment: outpatient opioid detoxification and/or maintenance therapy including methadone maintenance treat- ment You pay nothing 40% Partial Hospitalization Program 13 You pay nothing per episode 40% of up to $350 per day per episode Psychological testing to determine mental health diagnosis You pay nothing 40% Transcranial magnetic stimulation You pay nothing 40% Routine Outpatient Mental Health and Substance Abuse Services Professional (Physician) office visits 1 $30 per visit 40% Benefit Member Copayment 3 Services by Preferred, Participating, and Other Providers 4 Services by Non-Pre- ferred and Non-Partic- ipating Providers 5 Orthotics Benefits Office visits 1 $30 per visit 40% Orthotic equipment and devices 10% 40% Outpatient Prescription Drug Benefits Outpatient Prescription Drug coverage if selected as an optional Benefit by your Employer, is described in a Supplement included with this booklet. Outpatient X-Ray, Pathology, and Laboratory Benefits Outpatient diagnostic X-ray, pathology, diagnostic examination and clinical laboratory Services, including mammography and Pa- panicolaou test. See Radiological and Nuclear Imaging Benefits for CT scans, MRIs, MRAs, PET scans, etc. Outpatient Laboratory Center or Outpatient Radiology Center Note: Preferred Laboratory Centers and Preferred Radiology Cen- ters may not be available in all areas. $30 per visit 40% Benefit Member Copayment 3 Services by Preferred, Participating, and Other Providers 4 Services by Non-Pre- ferred and Non-Partici- pating Providers 5 PKU Related Formulas an...
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Mental Health and Substance Abuse Benefits. The Department of Administrative Services, with the active consultation and review of the JHCC, shall develop and implement a managed mental health and substance abuse program for all State employees enrolled in either Ohio Med, an HMO or other managed care program. The program shall be effective July 1, 1995, or as soon thereafter as is practicable. Upon the effective date of the program, the State shall contract for State employee mental health and substance abuse benefits only under this program. Premiums for the managed mental health/substance abuse program shall be calculated into the Ohio Med premium and shall be added to the HMO premiums. Should the State, upon consultation with the JHCC, determine that this managed care program is unfeasible or will create an undue financial burden to the State and/or its employees, it may then cancel the program. Programs must include the following features:
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Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administra- tor (MHSA) arranges and administers Mental Health and Substance Abuse Services for Blue Shield Members within California. All non-emer- gency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health and Sub- stance Abuse Services must be prior authorized by the MHSA. Routine Outpatient Mental Health and Sub- stance Abuse Services Benefits are provided for professional office visits for the diagnosis and treatment of Mental Health and Substance Abuse Conditions in the individual, Family or group setting. Non-Routine Outpatient Mental Health and Substance Abuse Services Benefits are provided for Outpatient Facility and professional services for the diagnosis and treat- ment of Mental Health and Substance Abuse Conditions. These services may also be provided in the office, home or other non-institutional setting. Non-Routine Outpatient Mental Health and Sub- stance Abuse Services include, but may not be lim- ited to the following:
Sample 1
Mental Health and Substance Abuse Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) arranges and administers Mental Health and Substance Abuse Services for Blue Shield Members within California. See the Urgent Services, Emergency Services, Out-Of- Area Program, or BlueCard Program sections for an explanation of how payment is made for Urgent Services or Emergency Services outside of the EPO Service Area or for out of state services. All Non-Emergency inpatient Mental Health and Substance Abuse Services, including Residential Care, and Non- Routine Outpatient Mental Health and Substance Abuse Services are subject to the Benefits Management Program and must be prior authorized by the MHSA. See the Benefits Management Program section for complete information.
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Related to Mental Health and Substance Abuse Benefits

  • Behavioral Health Services – Mental Health and Substance Use Disorder Inpatient - Unlimited days at a general hospital or a specialty hospital including detoxification or residential/rehabilitation per plan year. Preauthorization may be required for services received from a non-network provider. 0% - After deductible 40% - After deductible Outpatient or intermediate careservices* - See Covered Healthcare Services: Behavioral Health Section for details about partial hospital program, intensive outpatient program, adult intensive services, and child and family intensive treatment. Preauthorization may be required for services received from a non-network provider. 0% - After deductible 40% - After deductible Office visits - See Office Visits section below for Behavioral Health services provided by a PCP or specialist. Psychological Testing 0% - After deductible 40% - After deductible Medication-assisted treatment - whenrenderedby a mental health or substance use disorder provider. 0% - After deductible 40% - After deductible Methadone maintenance treatment - one copayment per seven-day period of treatment. 0% - After deductible 40% - After deductible Cardiac Rehabilitation Outpatient - Benefit is limited to 18 weeks or 36 visits (whichever occurs first) per coveredepisode. 0% - After deductible 40% - After deductible Chiropractic Services In a physician's office - limited to 12 visits per plan year. 0% - After deductible 40% - After deductible Dental Services - Accidental Injury (Emergency) Emergency room - When services are due to accidental injury to sound natural teeth. 0% - After deductible The level of coverage is the same as network provider. In a physician’s/dentist’s office - When services are due to accidental injury to sound natural teeth. 0% - After deductible 40% - After deductible Dental Services- Outpatient Services connected to dental care when performed in an outpatient facility * 0% - After deductible 40% - After deductible Dialysis Services Inpatient/outpatient/in your home 0% - After deductible 40% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Durable Medical Equipment (DME), Medical Supplies, Diabetic Supplies, Prosthetic Devices, and Enteral Formula or Food, Hair Prosthetics Outpatient durable medical equipment* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient medical supplies* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Outpatient diabetic supplies/equipment purchasedat licensed medical supply provider (other than a pharmacy). See the Summary of Pharmacy Benefits for supplies purchased at a pharmacy. 20% - After deductible 40% - After deductible Outpatient prosthesis* - Must be provided by a licensed medical supply provider. 20% - After deductible 40% - After deductible Enteral formula delivered through a feeding tube. Must be sole source of nutrition. 20% - After deductible 40% - After deductible Enteral formula or food taken orally * 20% - After deductible The level of coverage is the same as network provider. Hair prosthesis (wigs) - The benefit limit is $350 per hair prosthesis (wig) when worn for hair loss suffered as a result of cancer treatment. 20% - After deductible The level of coverage is the same as network provider. Early Intervention Services (EIS) Coverage provided for members from birth to 36 months. The provider must be certified as an EIS provider by the Rhode Island Department of Human Services. 0% - After deductible The level of coverage is the same as network provider. Education - Asthma Asthma management 0% - After deductible 40% - After deductible Emergency Room Services Hospital emergency room 0% - After deductible The level of coverage is the same as network provider.

  • SUBSTANCE ABUSE The dangers and costs that alcohol and other chemical abuses can create in the electrical contracting industry in terms of safety and productivity are significant. The parties to this Agreement resolve to combat chemical abuse in any form and agree that, to be effective, programs to eliminate substance abuse and impairment should contain a strong rehabilitation component. The local parties recognize that the implementation of a drug and alcohol policy and program must be subject to all applicable federal, state, and local laws and regulations. Such policies and programs must also be administered in accordance with accepted scientific principles, and must incorporate procedural safeguards to ensure fairness in application and protection of legitimate interests of privacy and confidentiality. To provide a drug-free workforce for the Electrical Construction Industry, each IBEW local union and NECA chapter shall implement an area-wide Substance Abuse Testing Policy. The policy shall include minimum standards as required by the IBEW and NECA. Should any of the required minimum standards fail to comply with federal, state, and/or local laws and regulations, they shall be modified by the local union and chapter to meet the requirements of those laws and regulations.

  • Mental Health The parties recognize the importance of supporting and promoting a psychologically healthy workplace and as such will adhere to all applicable statutes, policy, guidelines and regulations pertaining to the promotion of mental health.

  • Accident Prevention Health and Safety Committee The Employer and the Union agree that they mutually to maintain standards of safety and health in the Hospital in order to prevent accidents, injury, and illness. ected or Recognizing its responsibilities under the applicable legislation, the Hospital agrees to accept as a member of its Accident Prevention Health and Safety Committee, at least one (1) representative sel appointed by the Union from amongst Bargaining Unit employees. Such Committee shall identify potential dangers and means of improving health and safety programs, and recommend actions to be taken to improve conditions related to safety and health. The Hospital agrees to co-operate reasonably in providing necessary information to enable the Committee its functions. Meetings shall be held every second month or more frequently at the call of the Chair if required. The Committee shall maintain minutes of meetings and make the Same available for review. Any representative appointed or accordancewith hereof shall serve for a term of one (1) calendar year from the date of appointment which may be renewed for further of one (1) year. Time off for such to attend meetings of the Accident Prevention Health and Safety Committee in accordance with the foregoing shall be granted, and any attending such meetings during their regularly scheduled hours of work shall not lose regular as a result of such The Union agrees to endeavour to obtain the membership in the observation of all safety rules and practices. Safety Shoes The Hospital will provide sixty dollars ($60.00) annually effective April and eighty dollars ($80.00) effective April to each employee who is required by the Hospital, as delineated below, to wear safety footwear during the of his duties. The Hospital will require employees the following functions to wear appropriate Engineering Services; Grounds; Transport; (only where frequently working in storage areas). (as determined by the Hospital) heavy carts on a regular basis, e.g., linen carts, food wagons. ARTICLE BULLETIN BOARDS The Employer shall provide bulletin that all employees will have access to them have the right to post notices of meetings and such other notices as may be of interest to the membership. The wage increase listed on a retroactive to contact,in writing (with a copy to the Union) at their last-known entitle who have left its employ, to advise them of their any retroactive wage adjustment. Any employees who have employees shall have notice from the Hospital in which to claim from the Hospital any adjustment to their remuneration entitlement. The retroactive payments shall be made by separate cheques to the employees so entitled within sixty (60) days from the date of ratification. All other adjustments shall be effective as set out specifically in this Collective Agreement.

  • Substance Abuse Program The SFMTA General Manager or designee will manage all aspects of the FTA-mandated Substance Abuse Program. He/she shall have appointing and removal authority over all personnel working for the Substance Abuse Program personnel, and shall be responsible for the supervision of the SAP.

  • Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).

  • Substance Abuse Testing The Parties agree that it is in the best interest of all concerned to promote a safe working environment. The Union has no objection to pre-employment substance abuse testing when required by the Employer and further, the Union has no objection to voluntary substance abuse testing to qualify for employment on projects when required by a project owner. The cost and scheduling of such testing shall be paid for and arranged by the Employer. The Union agrees to reimburse the Employer for any failed pre-access Alcohol and Drug test costs.

  • Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.

  • SUBSTANCE ABUSE POLICY 6.6.1. Labor and Management are committed to providing employees with a drug-free and alcohol-free workplace. It is the goal to protect the health and safety of employees and to promote a productive workplace, and protect the reputation of Labor and Management and the employees.

  • Department of Health and Human Services An employee notified of a positive controlled substance or alcohol test result may request an independent test of their split sample at the employee’s expense. If the test result is negative, the Employer will reimburse the employee for the cost of the split sample test. An employee who has a positive alcohol test and/or a positive controlled substance test may be subject to disciplinary action, up to and including dismissal, based on the incident that prompted the testing, including a violation of the drug and alcohol free work place rules.

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